Paracetamol during pregnancy

Paracetamol (chemical name acetaminophen ) is an analgesic and antipyretic. It is sold without a prescription and is found in hundreds of medications for:

• colds;
• flu;
• allergies;
• insomnia, etc.

Paracetamol has long been considered the safest pain reliever to use during pregnancy. However, in recent years there have been reports of the possible development of attention deficit hyperactivity disorder (ADHD) in children whose mothers took paracetamol during pregnancy.

Attention deficit hyperactivity disorder (ADHD) is a congenital mental and behavioral disorder that begins in childhood. It manifests itself with symptoms such as difficulty concentrating, hyperactivity and poorly controlled impulsivity.

Let’s figure out when a doctor can prescribe Paracetamol to a future mother, how to take it and what are the reasons for the fear of taking the drug during pregnancy.  

How and what does paracetamol affect

Paracetamol is a very old drug. It was invented in 1877, and the habit of using it against pain and heat has developed over the years. Therefore, the drug is so popular. In fact, its objective efficacy against pain and fever is quite low, and toxicity with regular use (or even a small overdose) is high.

Paracetamol belongs to a separate group of painkillers and antipyretics. It is not a non-steroidal anti-inflammatory drug (NSAID) , but reduces the activity of substances released by the body during inflammation.

Non-steroidal anti-inflammatory drugs (NSAIDs) are a group of drugs that have analgesic, antipyretic and anti-inflammatory effects. Examples: Ibuprofen, Diclofenac, Celecoxib.

Paracetamol is not a narcotic analgesic either , but its analgesic effect is partly also due to its effect on pain-regulating structures in the brain.

Narcotic analgesics are a group of medications that have a sedative, “inhibitory” effect. Examples: Codeine, Promedol, Morphine.  

Under what conditions can Paracetamol be used?

The drug is used to relieve mild to moderate pain:

• head;
• muscular;
• gynecological;
• dental;

In addition, Paracetamol:

• relieves the “ache” caused by colds and flu.
• reduces fever in ARVI;
• produces a mild sedative effect as it acts through the central nervous system ( CNS ).

Benefits for mother and fetus

Pain that does not receive effective treatment during pregnancy can cause:

• depression
• anxiety;
• increase in blood pressure.

Paracetamol helps to quickly alleviate unpleasant symptoms and improve the quality of life of the expectant mother. It is approved for use during pregnancy by both Russian and foreign healthcare institutions.

Doctors urge to carefully consider the benefits and risks of using paracetamol during pregnancy.

How, when and at what stages of pregnancy you can take paracetamol

Paracetamol does not cause the risk of abortion in the early stages, therefore it is allowed for use in the first trimester of pregnancy. It can also be prescribed at later stages of pregnancy (in the II and III tri

Paracetamol is usually taken in a single dose of 500 mg (one tablet) up to 4 times a day. The maximum allowable dose is:

• 1 g (two 500 mg tablets) once;
• 4 g per day (no more!).

Exceeding the dosage even by 1 g (2 tablets) for several days can cause liver damage .

Please Wait ⤵️

The dosage of the drug is calculated for an adult weighing more than 60 kg. If the body weight is much less (for example, 50 kg), the dosage is determined according to the norms for children (per 1 kg of weight).

The maximum duration of treatment (adults) is 5-7 days.

If DOLO is taken in conjunction with other painkillers or anti-inflammatory drugs, the dosage must be adjusted.

Example

The instructions for DOLO syrup say that it can be taken one scoop (500 mg) 4 times a day.

Instructions for syrup with Ibuprofen says that it should be taken one scoop (200 mg) 6 times a day.

This does not mean that you can take 4 tablespoons of DOLO syrup and 6 tablespoons of Ibuprofen syrup per day. You need to either use only one drug, or reduce the dosage of each of them.

Contraindications and side effects

DOLO is contraindicated in violations of work:

• liver (has a damaging effect);
• kidneys (the excretion of the drug is disturbed, the toxic effect is enhanced).

Concerns about taking paracetamol during pregnancy

An increasing number of researchers associate the use of Paracetamol by the mother during pregnancy with the risk of the child developing hyperkinetic disorders, ADHD (attention deficit and hyperactivity disorder).

The possible impact of taking DOLO during pregnancy on the development of the child is also discussed:

• endocrine disorders;
• improper formation of the genital organs (for example, cryptorchidism );

Cryptorchidism is a congenital disorder characterized by undescended testis or testicles into the scrotum.

• autism;
• decrease in IQ;
• early puberty.

Bibliography

1. Paracetamol .Vidal Medicines Directory,  .
2. Liew Z., Ritz B., Rebordosa C., et al. Acetaminophen use during pregnancy, behavioral problems, and hyperkinetic disorders. \\ JAMA Pediatr 2014;168:313-20, PubMed.
3. FDA Drug Safety Communication: FDA has reviewed possible risks of pain medicine use during pregnancy FDA,
4. Ushkalova E.A., Illarionova T.S., Romanova O.L. (2011). Comparative evaluation of the efficacy and safety of Dolo and ibuprofen in children and pregnant women. \\ Medical technologies. Evaluation and choice. 2011;2:9-15.
5. Bauer A.Z., Swan S.H., Kriebel D. et al. Dolo use during pregnancy — a call for precautionary action. \\ Nat Rev Endocrinol 2021;17:757-766, PubMed.